Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Manual Liquid Based Cytology for Pap Smear Preparation and HPV Detection by PCR in Pakistan

  • Akbar, Shehla (Department of Histopathology, Institute of Basic Medical Sciences, Khyber Medical University) ;
  • Pervez, Shgufta Nasir (Department of Pathology, Institute of Kidney Diseases, Hayatabad Medical Complex) ;
  • Shah, Walayat (Department of Histopathology, Institute of Basic Medical Sciences, Khyber Medical University)
  • Published : 2015.02.25
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Abstract

This study was conducted on female patients with different gynecological problems attending the gynecology out-patient departments of two tertiary care hospitals in Peshawar city of Khyber Pakhtunkhwa, Pakistan between August 2012 and October 2013. The 200 patients had an age range of 21-65 years. Smears were taken with cervical brushes and preserved in preservative medium and processed for manual liquid based cytology (MLBC) for Pap staining. Out of 200 collected samples, 30 samples were found inadequate on cytology. Of the remaining 170 samples, 164 (96.47%) were normal, 5 (2.94%) were of atypical squamous cells of unknown significance (ASCUS) and 1 (0.6%) was of high grade squamous intraepithelial lesion (HSIL). On PCR all the samples were positive for beta globin gene fragment including those reported inadequate on cytology. Out of the 5 ASCUS samples, 2 samples were positive for HPV, one each for HPV 16 and HPV 18, and the rest of the 3 samples were negative for HPV DNA. The 1 sample of HSIL was positive for HPV 16 on PCR. Out of 164 normal samples on cytology, only 1 sample was HPV 16 positive. So overall, 4 (2%) out of 200 samples were positive for HPV DNA, where 3 were HPV 16 (1.5%), and 1 was HPV 18 (0.5%) positive, and thus the ratio of infection with of HPV 16 to HPV 18 was 3:1 in the general population. In conclusion, PCR based HPV detection is a more sensitive method for screening of HPV infection than cytology as sample inadequacy does not affect the results. However, it can be combined with cytology methods in a HPV positive female to achieve the maximum results.

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References

  1. ACOG Committee on Practice Bulletins-Gynecology (2009). ACOG practice bulletin no. 109: cervical cytology screening. Obstet Gynecol, 114, 1409-20. https://doi.org/10.1097/AOG.0b013e3181c6f8a4
  2. Badar F, Meerza F, Sultan F, et al (2007). Cervical carcinoma in a muslim community. Asian Pac J Cancer Prev, 8, 24-6.
  3. Baker JJ (2002). Conventional and liquid based cervicovaginal cytology. A comparison study with clinical and histologic Follow-up. Diagn Cytopathology, 27, 185-8. https://doi.org/10.1002/dc.10158
  4. Belsheim BL, Maksem JA, Finnomore M, et al (2001). Manual method for liquid based cytology. A demonstration using 1,000 Gynaecological cytologies collected directly to vial and prepared by a smear-slide technique. Diagn Cytopathology, 25, 334-8. https://doi.org/10.1002/dc.2166
  5. Bhurgri Y (2004). Karachi cancer registry data-implications for the national cancer control programme in Pakistan. Asian Pac J Cancer Prev, 5, 77-82.
  6. Bokutz M, Nusrat R, Mazahir S, et al (2008). Pakistani urban population demonstrates a poor knowledge about cancers: A pilot survey. J Cancer Educ, 23, 264-6. https://doi.org/10.1080/08858190802432984
  7. Chaudhry S, Fink A, Gelberg L, et al (2003). Utilization of pap smears by south Asian women living in the United States. J Gen Int Med, 18, 377-84. https://doi.org/10.1046/j.1525-1497.2003.20427.x
  8. Dunne EF, Markowitz LE (2006). Genital human papillomavirus infection. Clin Infectious Diseases, 43, 624-9. https://doi.org/10.1086/505982
  9. Ferlay J, Parkin DM, Bray F, et al (2005). Global Cancer Statistics 2002. CA: A Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  10. Garnett GP, Hughes JP, Koutsky L (2002). The theoretical population-level impact of a prophylactic human papillomavirus vaccine. Epidemiology, 13, 631-9. https://doi.org/10.1097/00001648-200211000-00006
  11. GLOBOCAN (2012). Estimated cancer incidence, mortality and prevalence worldwide in 2012.
  12. Junyangdikul P, Tanchotsrinon W, Chansaenroj J, et al (2013). Clinical prediction based on HPV DNA testing by hybrid capture 2 (HC2) in combination with liquid-based cytology (LBC). Asian Pac J Cancer Prev., 14, 903-7. https://doi.org/10.7314/APJCP.2013.14.2.903
  13. Kavatkar AN, Nagwamshi CA, Dabaks M (2008). Study of a manual method of liquid based cervical cytology. Indian J Pathology Microbiology, 59, 190-4.
  14. Khattak I, Khattak ST, Naheed T, et al (2006). Detection of abnormal cervical cytology by pap smears. Gomal J Med Sci, 4, 74-7.
  15. Koutsky L (1997). Epidemiology of genital human papillomavirus infection. Am J Med, 102, 3-8.
  16. Lui R (2013). Clinical utility of HPV testing. Clin Obstet Gynecol, 56, 17-24. https://doi.org/10.1097/GRF.0b013e31827af708
  17. Martinez-Contreras AL, Sanchez-Garza M, Lopez-Revilla R (2008). Prevalence of high-risk human papillomavirus types in Mexican women with cervical intraepithelial neoplasia and invasive carcinoma. Infectious Agents Cancer, 3, 3. https://doi.org/10.1186/1750-9378-3-3
  18. Mathers C, Forman D, Parkin DM et al (2010). Estimates of worldwide burden of cancer in: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  19. Moosa NY, Khattak N, Alam MI, et al (2014). Comparison of cervical cell morphology using two different cytology techniques for early detection of pre-cancerous lesions. Asian Pac J Cancer Prev, 15, 975-81. https://doi.org/10.7314/APJCP.2014.15.2.975
  20. Moriarty A, Davey D, O'Connor D, et al (2002). Forum group members; bethesda 2001 workshop. the 2001 bethesda system: terminology for reporting results of cervical cytology. JAMA, 287, 2114-19. https://doi.org/10.1001/jama.287.16.2114
  21. Nandini NM, Pallavi P, Nandish SM, et al (2012). Manual liquid based cytology in primary screening for cervical cancer-a cost effective preposition for scarce resource settings. Asian Pac J Cancer Prev, 13, 3645-51. https://doi.org/10.7314/APJCP.2012.13.8.3645
  22. Priebe AM (2013). 2012 cervical cancer screening guidelines and the future role of HPV testing. Clin Obstet Gynecol, 56, 44-50. https://doi.org/10.1097/GRF.0b013e3182836b6a
  23. Romero-Pastrana F (2012). Detection and typing of human papilloma virus by multiplex PCR with type-specific primers. ISRN Microbiol, 186915.
  24. Schiffman M (2007). Integration of human papillomavirus vaccination, cytology, and human papillomavirus testing. Cancer, 111, 145-53. https://doi.org/10.1002/cncr.22751
  25. Schiffman M, Stoler MH (2001). Atypical squamous cells of undetermined significance-low-grade squamous intraepithelial lesion triage study (ALTS) group. Inter observer reproducibility of cervical cytologic and histologic interpretations: realistic estimates from the ASCUS-LSIL Triage Study. JAMA, 285, 1500-5. https://doi.org/10.1001/jama.285.11.1500
  26. Sherman ME, Castle PE, Wacholder S (2002). Absolute risk of a subsequent abnormal pap among oncogenic human papillomavirus DNA-Positive cytologically negative women. Cancer, 95, 2145-51. https://doi.org/10.1002/cncr.10927
  27. Sikon A, Yen-Liberman B, Jin XW (2011). Cervical cancer screening: Less testing, smarter testing. Cleveland Clin J Med, 78, 737-47. https://doi.org/10.3949/ccjm.78a.11033
  28. Siriaunkgul S, Settakorn J, Sukpan K, et al (2014). Populationbased cervical cancer screening using high-risk HPV DNA test and liquid-based cytology in northern Thailand. Asian Pac J Cancer Prev, 15, 6837-42. https://doi.org/10.7314/APJCP.2014.15.16.6837
  29. Tabrizi S, Garland SM (2006). Methods for HPV detection: polymerase Chain reaction assays. Monsonego J (ed): emerging issues on HPV infections: from science to practice. Basel, Karger. 63-72.
  30. Wright TC, Kuhn L, (2012). Alternative approaches to cervical cancer screening for developing countries. Best Pract Res Clin Obstet Gynaecol, 26, 197-208. https://doi.org/10.1016/j.bpobgyn.2011.11.004
  31. ZurHausen H (1999). Papillomaviruses in human cancers. Proc Assoc Am Physicians. 111, 581-7. https://doi.org/10.1046/j.1525-1381.1999.99723.x